Aim To discuss important topics regarding the dental procedures performed in patients before, during and after the radiotherapy treatment. The biological effects of ionizing radiation on bone tissue focusing on clinical care will be described. The invasive and not invasive procedures after radiotherapy treatment in the head and neck region will be addressed using scientific evidences to determine the appropriate moment for tooth extractions, periodontal management, and preventive procedures for osteoradionecrosis. Methods Thirty-three studies including original studies and reviews were selected in MEDLINE database (PubMed). No year of publication restriction was applied. Language was restricted to the English, and the following Medical Subject Heading terms were used: radiotherapy, osteoradionecrosis, dental management. Studies of osteoradionecrosis involving clinical management of irradiated patients, with an emphasis on updated guidelines and protocols were selected. Results Care in dental procedures were related about restorative treatment, endodontic treatment, rehabilitation for edentulous regions using prostheses and implants and periodontal procedures before, during and after RTX treatment. Conclusions The dental procedures should and can be performed before, during but also after radiotherapy. However, the clinical procedures should be less invasive as possible. A maintenance plan that reduces the necessity for major and more invasive treatments after radiotherapy is recommended.

SUMMARY OBJECTIVE: This study aimed to translate, cross-culturally adapt, and validate the Heart Disease Fact Questionnaire into Brazilian Portuguese. METHODS: The Brazilian version of the Heart Disease Fact Questionnaire was developed through the processes of translation, back-translation, review committee, and pre-test. Test-retest reliability was measured using the intraclass correlation coefficient and the kappa coefficient. Internal consistency was measured using Cronbach's alpha. For construct validity, the total Heart Disease Fact Questionnaire score was correlated with the Diabetes Knowledge Scale and the Diabetes Attitudes Questionnaire. Ceiling and floor effects were also evaluated in this study. RESULTS: For construct validity and floor and ceiling effect measurements, a total of 100 participants were selected. Reliability was measured using a sub-sample of 30 participants from the total sample. We identified adequate values of reliability (kappa between 0.22 and 1.00 and ICC=0.75) and internal consistency (Cronbach's alpha=0.79). We observed adequate correlations of the Heart Disease Fact Questionnaire score with Diabetes Knowledge Scale (r=0.348) and Diabetes Attitudes Questionnaire (r=0.136). No ceiling or floor effects found. CONCLUSION: Brazilian Portuguese version of the Heart Disease Fact Questionnaire has adequate psychometric properties according to the best scientific recommendations.

RESUMO Objetivo: Este estudo avaliou a prevalência do bruxismo em crianças e sua associação a características clínicas e do sono. Métodos: A amostra foi constituída por 239 crianças, de 7 a 10 anos de idade, provenientes de uma escola pública e uma privada de São Luís (MA). O bruxismo foi investigado por meio do relato dos pais quanto a sons de ranger de dentes durante o sono, qualidade do sono e aspectos clínicos intra e extrabucais relacionados ao agravo. Foi realizada análise descritiva e aplicado os testes c2 de Pearson, c2 de Tendência Linear e Exato de Fisher, ao nível de significância de 5%. Resultados: A prevalência de bruxismo foi de 19,7%. Das crianças que apresentaram bruxismo, 17% tinham qualidade do sono ruim, 44,1% dormiam até 9 horas por noite, 82,2% tinham sonolência diurna e 17,9% se sentiam cansadas ou com dor nos músculos da face ao acordar. Conclusão: Com base nos achados, a prevalência de bruxismo do sono foi significativa. Não foi observada associação com os fatores investigados, embora a sonolência diurna tenha sido a característica mais prevalente.

ABSTRACT Objective: The aim of the present study was to evaluate the prevalence of bruxism in children and its association with clinical and sleep characteristics. Methods: The study sample composed of 239 children aged 7 to 10 years enrolled in a public and a private school in the city of São Luís (MA). Bruxism was investigated based on parental reports of teeth grinding at night, sleep quality, and both intraoral and extraoral clinical aspects related to the condition. Data analysis involved descriptive statistics, Pearson’s chi-squared (c2) test, the linear trend c2 test, and Fisher’s exact test with a 5% significance level. Results: The prevalence of bruxism was 19.7%. Among the children with bruxism, 17% had poor sleep quality, 44.1% slept up to nine hours per night, 82.2% had daytime sleepiness, and 17.9% felt tiredness or pain in the facial muscles upon waking. Conclusions: Based on the present findings, the prevalence of sleep bruxism was significant. No significant associations were observed with the factors investigated, although daytime sleepiness was found to be the most prevalent characteristic of bruxism.

RESUMO Introdução: rotineiramente na terapia ortodôntica fixa, utilizam-se braquetes estéticos combinados com fios metálicos, principalmente devido a algumas desvantagens no uso clínico dos fios estéticos. A percepção estética dos leigos nessa situação precisa ser explorada na literatura. Objetivo: o objetivo deste estudo transversal foi avaliar a percepção estética dos leigos em relação aos fios ortodônticos metálicos recobertos ou não por materiais estéticos. Três faixas etárias, dos dois sexos, foram avaliadas. Métodos: uma paciente usando aparelho ortodôntico fixo estético foi fotografada com os seguintes fios ortodônticos: aço inoxidável, níquel-titânio (NiTi), NiTi recoberto por resina epóxica e NiTi recoberto por ródio. As fotografias foram avaliadas por 90 leigos, utilizando-se uma escala visual analógica de 100-mm. Ambos os sexos e diferentes faixas etárias (18-30, 31-45 e acima de 46 anos) foram avaliados. As comparações entre os fios e entre as faixas etárias foram realizadas aplicando-se os testes ANOVA e Tukey. Os sexos foram comparados utilizando-se o teste de Mann-Whitney. Resultados: os resultados demonstraram que os avaliadores consideraram o fio recoberto por resina epóxica como o mais estético (60,64 ± 13,04) e o fio de NiTi foi classificado como o menos estético (30,82 ± 7,79) (p< 0,05). Apenas a faixa etária de 31-45 anos considerou o fio de NiTi menos estético, quando comparada às outras faixas etárias; para os outros fios, não foi observada diferença estatisticamente significativa entre as faixas etárias. Não foi detectada diferença entre os sexos. Conclusões: os resultados indicaram que os fios estéticos recobertos melhoraram o aspecto visual dos braquetes cerâmicos. O fio metálico recoberto por resina epóxica foi considerado a opção mais estética.

ABSTRACT Introduction: Aesthetic brackets are routinely combined with metallic wires in fixed orthodontic therapy, mainly due to the disadvantages of the clinical use of aesthetic archwires. The current situation needs to be explored in the literature by considering laypersons’ perceptions. Objective: The objective of this cross-sectional study was to evaluate laypersons’ aesthetic perceptions of metal archwires with and without aesthetic coating. Three age ranges and both sexes were evaluated. Methods: A volunteer using fixed aesthetic orthodontic appliance was photographed wearing the following archwires: stainless steel, nickel-titanium (NiTi), NiTi coated with epoxy resin and NiTi coated with rhodium. Using a 100-mm visual analog scale, 90 laypersons evaluated the photographs. Sex and age ranges (18-30, 31-45, over 46 years of age) were evaluated. The comparisons between the archwires and between age ranges were made using ANOVA and Tukey’s test. Genders were compared using Mann-Whitney test. Results: The results showed that the evaluators considered the archwire coated with epoxy resin to be the most aesthetic (60.64 ± 13.04) and the NiTi wire to be the least aesthetic (30.82 ± 7.79) (p< 0.05). Only the range of 31-45 years of age considered the NiTi archwires less aesthetic, when compared with the other age groups. For the other archwires, no statistically significant difference were found between the age groups. No differences between the sexes were detected. Conclusions: The results indicated that the aesthetic coated archwires represent an improvement in the visual aspect of ceramic brackets. The epoxy-coated metal wire was considered the most aesthetic option.

Abstract The aim of the present study was to confirm the discriminant validity (obtained using traditional statistical methods) of the Early Childhood Oral Health Impact Scale (ECOHIS) between preschool children with and without caries (mean score) through an evaluation of the effect size. A systematic search of electronic databases and a manual search were performed for studies published up to December 2015 involving the use of the ECOHIS for the evaluation of the impact of dental caries on oral health–related quality of life (OHRQoL) among preschool children. Two independent raters performed the selection of the studies and data extraction. Only papers published in English and Spanish were selected. No restrictions were imposed regarding the year of publication. Twelve studies were included, and the magnitude of standardized differences between the means of the “without caries” and “with caries” groups was calculated using Cohen’s d. Most studies demonstrated a large magnitude in the difference between the groups evaluated. The estimate of the effect size confirmed the discriminant validity of the ECOHIS obtained through traditional statistics. Thus, the magnitude of the difference should be considered an important analytical tool for the confirmation of statistical findings regarding null hypotheses and demonstrates the clinical significance of these research results.

<p>O objetivo deste estudo foi avaliar a influência dos sistemas adesivos simplificados (condicionamento ácido total e auto-condicionante) e fluorfosfato acidulado a 1,23% (FFA) na resistência de união ao microcisalhamento (μ-RUC) de resinas compostas em molares e incisivos decíduos. O esmalte vestibular de quarenta molares e quarenta incisivos decíduos foi tratado com Clearfil SE Bond (CSE, Kuraray) ou Adper Single Bond 2 (SB2, 3M/ESPE). Cada grupo foi subdividido com base no tratamento prévio do esmalte com ou sem aplicação tópica de FFA a 1,23%. Em seguida, matrizes foram posicionadas e preenchidas com resina composta e posterior fotopolimerização. Depois da armazenagem em água destilada a 37±1 °C por 24 h, os espécimes foram submetidos ao μ-RUC em uma máquina de ensaio universal. Teste Kruskal-Wallis e Mann-Whitney (p<0,05) mostraram que a aplicação prévia de FFA a 1,23% levou a uma redução significativa na resistência de união. O tipo de adesivo não exerceu influência significativa na resistência de união. Na análise intergrupos, entretanto, redução significativa na resistência de união foi encontrada para os incisivos quando CSE foi empregado sem FFA. Falha adesiva foi o tipo de fratura mais comum. A resistência de união foi afetada pela aplicação de FFA a 1,23% e tipo de dente.</p>

<p>The aim of this study was evaluate in vitro the influence of simplified adhesive systems (etch-and-rinse and self-etching) and 1.23% acidulated phosphate fluoride (APF) on the microshear bond strength (μ-SBS) of composite resins on primary molars and incisors. Forty primary molars and forty incisors vestibular enamel was treated with either the self-etching Clearfil SE Bond (CSE, Kuraray) or etch-and-rinse Adper Single Bond 2 (SB2, 3M/ESPE) adhesive system. Each group was subdivided based on the prior treatment of the enamel with or without the topical application of 1.23% APF. Thereafter, matrices were positioned and filled with composite resin and light cured. After storage in distilled water at 37±1°C for 24 h, the specimens were submitted to μ-SBS in a universal testing machine. Kruskal-Wallis and Mann-Whitney tests (p<0.05) showed that the prior application of 1.23% APF led to a significant reduction in bond strength. The type of adhesive exerted no significant influence bond strength. In the inter-group analysis, however, significantly bond strength reduction was found for the incisors when CSE was employed with APF. Adhesive failure was the most common type of fracture. The bond strength was affected by the prior application of 1.23% APF and type of tooth.</p>

O objetivo do estudo foi estimar a prevalência de problemas de espaço dentário em adolescentes brasileiros e fatores associados utilizando-se dados do inquérito SB Brasil 2010. Os desfechos avaliados foram os problemas de espaço dentário: déficit (apinhamento e desalinhamento) e excesso (diastema e espaçamento) obtidos pelo Índice de Estética Dental. A associação de variáveis independentes aos desfechos foi verificada a partir de um modelo hierarquizado em quatro níveis: contextuais, socioeconômicas e demográficas, acesso aos serviços e morbidade bucal. A análise estatística foi realizada utilizando-se teste qui-quadrado, Regressão de Poisson uni e multivariada, estimando-se razões de prevalências (RP). A prevalência total de problemas de espaço foi de 71,43%, sendo o desalinhamento o tipo mais comum (56,4%). Associaram-se significativamente ao excesso de espaço: idade de 16, 18 e 19 anos, não ser branco (RP = 1,75), percepção de problemas na fala (RP = 1,72) e bolsa periodontal 4-5mm (RP = 1,56). Para déficit de espaço: renda familiar até 3 salários mínimos, visita ao dentista há 1 ano ou mais (RP = 1,19) e ter em média um ou mais dentes cariados (RP = 1,32). Houve prevalência de problemas de espaço, destacando-se como potenciais fatores de risco variáveis socioeconômicas e sociodemográficas e de morbidade.

The scope of this study was to estimate the prevalence of dental spacing problems and associated factors among adolescents using data from the SB Brazil 2010 survey. The outcomes evaluated were dental spacing problems: space deficit (crowding and misalignment) and excess space (diastema and spacing) obtained using the DAI index. The association of independent variables with outcomes was assessed using a hierarchical model with four levels: contextual, socioeconomic and demographic characteristics, access to services and dental morbidity. Statistical analysis was performed using the chi-square test and univariate and multivariate Poisson distribution to estimate prevalence ratios (PR). The overall prevalence of space problems was 71.43%, with misalignment being the most common type (56.4%). The following aspects were significantly associated with excess space: age of 16, 18 and 19 years; being non-Caucasian (PR = 1.75), perception of speech problems (PR = 1.72) and periodontal pockets 4-5mm (RP = 1.56). For space deficit: family income up to 3 minimum wages, dental visit 1 year or more previously (PR = 1.19) and having one or more decayed teeth on average (PR = 1.32). There was a prevalence of spacing problems, especially with socioeconomic and demographic variables and morbidity as potential risk factors.

O objetivo do estudo foi estimar a prevalência de problemas de espaço dentário em adolescentes brasileiros e fatores associados utilizando-se dados do inquérito SB Brasil 2010. Os desfechos avaliados foram os problemas de espaço dentário: déficit (apinhamento e desalinhamento) e excesso (diastema e espaçamento) obtidos pelo Índice de Estética Dental. A associação de variáveis independentes aos desfechos foi verificada a partir de um modelo hierarquizado em quatro níveis: contextuais, socioeconômicas e demográficas, acesso aos serviços e morbidade bucal. A análise estatística foi realizada utilizando-se teste qui-quadrado, Regressão de Poisson uni e multivariada, estimando-se razões de prevalências (RP). A prevalência total de problemas de espaço foi de 71,43%, sendo o desalinhamento o tipo mais comum (56,4%). Associaram-se significativamente ao excesso de espaço: idade de 16, 18 e 19 anos, não ser branco (RP = 1,75), percepção de problemas na fala (RP = 1,72) e bolsa periodontal 4-5mm (RP = 1,56). Para déficit de espaço: renda familiar até 3 salários mínimos, visita ao dentista há 1 ano ou mais (RP = 1,19) e ter em média um ou mais dentes cariados (RP = 1,32). Houve prevalência de problemas de espaço, destacando-se como potenciais fatores de risco variáveis socioeconômicas e sociodemográficas e de morbidade.

The scope of this study was to estimate the prevalence of dental spacing problems and associated factors among adolescents using data from the SB Brazil 2010 survey. The outcomes evaluated were dental spacing problems: space deficit (crowding and misalignment) and excess space (diastema and spacing) obtained using the DAI index. The association of independent variables with outcomes was assessed using a hierarchical model with four levels: contextual, socioeconomic and demographic characteristics, access to services and dental morbidity. Statistical analysis was performed using the chi-square test and univariate and multivariate Poisson distribution to estimate prevalence ratios (PR). The overall prevalence of space problems was 71.43%, with misalignment being the most common type (56.4%). The following aspects were significantly associated with excess space: age of 16, 18 and 19 years; being non-Caucasian (PR = 1.75), perception of speech problems (PR = 1.72) and periodontal pockets 4-5mm (RP = 1.56). For space deficit: family income up to 3 minimum wages, dental visit 1 year or more previously (PR = 1.19) and having one or more decayed teeth on average (PR = 1.32). There was a prevalence of spacing problems, especially with socioeconomic and demographic variables and morbidity as potential risk factors.

The aim of this study was to determine the level of agreement between reports by adolescents and their mothers regarding the impact of oral health on the adolescents' quality of life. The sample consisted of 960 pairs of adolescents aged 11 to 14 years and their mothers. The Brazilian version of the Parental-Caregiver Perceptions Questionnaire (P-CPQ) and the short form of the Child Perceptions Questionnaire (CPQ11-14) were administered. Agreement on the total scale and the subscales was determined through a comparison of mean values. The means of the directional and absolute differences were also determined. Agreement on each item on the group level and in the individual pairs was analyzed using the Intraclass Correlation Coefficient (ICC). The difference between the means and the directional differences were significant for the total score as well as for the functional limitation and social well-being subscales (p < 0.001). The ICC for the total P-CPQ and CPQ11-14 scores was 0.43. The ICC indicated weak agreement on the subscales, ranging from 0.36 to 0.40. Agreement between reports by adolescents and their mothers regarding oral health-related quality of life (OHRQoL) was moderate, indicating that both perspectives should be considered.

The aim of the present study was to identify risk factors for facial fractures in patients treated in the emergency department of a hospital. The medical charts of 1121 patients treated in an emergency ward over a three-year period were analyzed. The independent variables were gender, age, place of residence (urban or rural area) and type of accident. The dependent variables were fractured mandible, zygoma, maxilla, nasal bone and more than one fractured facial bone. Statistical analysis was performed using the chi-square test (a < 0.05), univariate and multivariate Poisson distributions and the logistic regression analysis (p < 0.20). Maxillofacial trauma was recorded in 790 charts (70.5%), with 393 (35.1%) charts reporting facial fractures. Motorcycle accidents were found to be the main risk factor for mandibular fractures (PR = 1.576, CI = 1.402-1.772) and simultaneous fractures of more than one facial bone (OR = 4.625, CI = 1.888-11.329) as well as the only risk factor for maxillary bone fractures (OR = 11.032, CI = 5.294-22.989). Fractures of the zygomatic and nasal bones were mainly associated with accidents involving animals (PR = 1.206, CI = 1.104-1.317) and sports (OR = 8.710, CI = 4.006-18.936), respectively. The determinant for the majority of facial fractures was motorcycle accidents, followed by accidents involving animals and sports.

The aim of the present study was to determine the prevalence of dental trauma and associated factors among a sample of patients with severe cerebral palsy. The sample was made up of 120 individuals equally divided into two groups. The group with cerebral palsy was made up of 60 patients diagnosed with the spastic form of the disease. The control group was made up of 60 individuals with no mental impairment. Questionnaires were used to collect information on individual, socioeconomic and behavioral characteristics. Dental trauma was assessed based on the clinical chart of each participant, on a questionnaire and on a clinical evaluation to determine past injuries. Mouth mirrors and millimeter periodontal probes (Community Periodontal Index probe) were used to measure overjet. Lip seal and breathing type were determined during the clinical exams and interviews. Statistical analysis involved the chi-square test (p < 0.05) and multivariate logistic regression (forward stepwise procedure). The prevalence of dental trauma was greater among individuals with cerebral palsy (18%) than in the control group (5%), with the difference achieving statistical significance (p = 0.023). Individuals with lip incompetence had a greater chance of exhibiting dental trauma (OR [CI 95%] = 3.81 [1.19-12.24]). The prevalence of dental trauma among individuals with cerebral palsy was high. A lack of lip seal was identified as a factor directly associated to this prevalence.